- Discussion:
- insufficiency frxs of sacrum and pelvis may be confused w/
metastatic lesions,
especially if bony resorption occurs at frx ends;
- these injuries may also occur in patients with known malignant disease who
have a sudden onset of pain in the lower back, hip, or groin;
- they may occur with normal activities such as walking;
- Bone Scan:
- useful in patients with insufficiency fractures;
- look for vertical increase in uptake of radionuclide;
- w/ bilateral fractures, an H-shaped distribution ("Honda sign");
- pts who have these patterns should have follow-up CT scans thru
sacrum in order to confirm the diagnosis;
- Management:
- complete healing may take upto 9 months;
- patients require protected wt bearing in order to avoid late displacement
and possible malunion;
- patient also need to be protected from
sacral decubiti;
Occult sacral fractures in osteopenic patients.
Transverse fractures of the sacrum. A report of six cases.
Conservative management of transverse fractures of the sacrum with
neurological features. A report of four cases.
Osteoporotic sacral fractures: a clinical study.
Rawlings CE III, Wilkins RH, Martinez S, Wilkinson RH Jr.
Neurosurgery 1988;22:72-76.
Sacral insufficiency fractures: an often unsuspected cause of low back pain.
Stroebel RJ, Ginzburg WW, McLeod RA.
J Rheumatol 1991;18: 117-119.
Insufficiency fractures of the sacrum.
Cooper KL, Beabout JW, Swee RG.
Radiology 1985;156:15-20.
Magnetic resonance appearance of sacral insufficiency fractures.
Brahme SK, Cervilla V, Vint V, Cooper K, Kortman K, Resnick D.
Skeletal Radiol 1990;19:489-493.
Spontaneous osteoporotic fracture of the sacrum: an unrecognized syndrome of the elderly.
Lourie H.
JAMA 1982;248:715-717.
Unsuspected sacral fractures: detection by radionuclide bone scanning.
Schneider R, Yacovone J, Ghelman B.
AJR 1985;144:337-341.
Detection of osteoporotic sacral fractures with radionuclides.
Ries T.
Radiology 1983;146:783-785.
